Provider Demographics
NPI:1447881396
Name:NAVAH PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:NAVAH PHYSICAL THERAPY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMILA
Authorized Official - Middle Name:CSHATEL RAWLINGS
Authorized Official - Last Name:LOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:301-793-1082
Mailing Address - Street 1:77 KETTERING DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1676
Mailing Address - Country:US
Mailing Address - Phone:240-312-2010
Mailing Address - Fax:240-312-2011
Practice Address - Street 1:77 KETTERING DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-1676
Practice Address - Country:US
Practice Address - Phone:240-312-2010
Practice Address - Fax:240-312-2010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-29
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty